NPIMap

Organization Active NPI

Bender Medical Group

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1679912919
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BENDER MEDICAL GROUP
Practice address
313 W Drake Rd
Fort Collins, CO 80526-2846
Phone
(970) 482-8881
Fax
(970) 482-9646
NPI assigned
Jun 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julie M Desaire
Title
Cbdo
Phone
(970) 225-5107

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 32679 CO

Addresses

Primary practice location

313 W Drake Rd
Fort Collins, CO 80526-2846

Mailing address

313 W Drake Rd
Fort Collins, CO 80526-2846
Phone (970) 482-8881

Other names 1

  • Miramont Family Medicine Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL info@miramont.us Direct

National Provider Directory

National Provider Directory
Tax ID family
Bender Medical Group Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1679912919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 W DRAKE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262846",
            "telephone_number": "970-482-8881",
            "fax_number": "970-482-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W DRAKE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262846",
            "telephone_number": "970-482-8881",
            "fax_number": "970-482-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENDER MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-20",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "DESAIRE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CBDO",
        "authorized_official_telephone_number": "970-225-5107"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "32679",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@miramont.us",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "313 W Drake Rd",
            "city": "Fort Collins",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805262846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Miramont Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Miramont Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.